Tanaka has partially torn elbow ligament, rehab recommended

After traveling from Cleveland to New York to Seattle within the last 48 hours, Masahiro Tanaka‘s elbow was finally examined by team Dr. Ahmad on Thursday night. Brian Cashman confirmed his ace right-hander has been diagnosed with a partially torn ulnar collateral ligament by Ahmad and two other doctors. All three recommended rehab — not Tommy John surgery — because the tear is small.

Tanaka, 25, will receive a platelet-rich plasma injection on Monday and eventually begin a throwing program. If all goes well, he could be back on a mound within six weeks, so the best case scenario has him back in pinstripes in late-August. Cashman noted other pitchers in the organization have successfully rehabbed from similar tears without saying who those pitchers were. Surgery can not be completely ruled out until the rehab program is complete. Here is what Cashman said during his conference call, courtesy of Chad Jennings:

“He has seen three physicians, our chief physician, Chris Ahmad, David Altchek and he has seen Neil elAttrache. All three are in agreement with a diagnosis of a new injury; a partially torn ligament in his throwing arm. The recommendation on the treatment is a rehab protocol that would begin with one PRP injection and a throwing program after an exercise routine. The ligament tear in question is considered small and we, the Yankees, have had success with pitchers that have had this.

“It doesn’t rule out the possibility of Tommy John (surgery) in a failed attempt, but all three doctors agree on the diagnosis and the rehab protocol. We are going to follow their recommendation and none of them recommend surgery at this time. They’re all hopeful that in roughly maybe a six-week period that we will have a pitcher back if he responds positively.”

The most notable example of a pitcher who successfully rehabbed a partially torn ligament is Adam Wainwright, who was able to continue pitching for a half-decade before going under the knife. Ervin Santana has pitched with a partially torn ligament the last few years as well. The odds are strongly in favor of Tanaka needing elbow reconstruction at some point in his career — once a ligament tears, it’s usually only a matter of time before it goes completely — but Cashman said all three doctors do not feel surgery is necessary at this point.

I understand the fear that all they’re doing is delaying the inevitable by trying rehab, but given where they are in the season, having the surgery now would likely knock Tanaka out until sometime next August. Three doctors all agree surgery is avoidable and that Tanaka has a chance to return to the mound this season. Surgery is always the last resort — you don’t want to cut into the elbow of a world class pitcher unless you absolutely have to — and if there’s a possibility it can be avoided, they have to try.

Now, obviously the injury hurts the Yankees on the field immensely. Tanaka was by far the club’s best pitcher and they were already without CC Sabathia (knee), Michael Pineda (shoulder), and Ivan Nova (elbow). None of those four is returning anytime soon. Somehow 39-year-old Hiroki Kuroda is the only member of the Opening Day rotation left standing. Tanaka’s partially torn ligament is not the worst case scenario, but losing him for at least six weeks is a devastating blow to a pitching staff already thinned by injury.

How many “partially torns” have healed completely without further problems via rehab? Just curious if anyone here is aware of other examples. Seems to me that when we hear of partially torns, within a period of time we hear of TJ.

rbibaseball

Adam Wainwright is a prime example

qwerty

Oh what precisely? He had tj surgery.

Old Man Time

He had a partial tear years before his TJS.

rbibaseball

he pitched for 5 years on a torn UCL, and the full tear didn’t happen until he reached behind his head while sleeping.

PoopChute

This news is even worse than a complete tear… If it was torn badly then he could just have the surgery and be back in the later part of next year… Now we’ll wait 6 weeks, he’ll come back for a few starts, completely tear the ligament, and then have his TJS and miss all of next year.

Awful.

Looser trader droids FotD™

This is, beyond a shadow of a doubt, the FotD™.

Yangeddard Solarte

Start the rehab now, they’re doing just fine without him. Solarte’s back to give the offense a boost. Zelous is giving us power, Frankie’s been on base twice tonight. Greene, McCarthy and BGDP are going to win this series in Cleveland.

Ricky

yeah totally because that’s going to happen most nights and solarte will bat .500 with 20 home runs to lead the yankees to the post season..

Someone got it :) Just trying to keep it light in the face of more downturns in Yankee universe. Phelps and career MilLBers are doing their part too tonight. Thank god!

Jorge Steinbrenner

I just saw it now. I would have had your back, brutha.

FIPster Doofus

Great reference. Great handle, too.

Looser trader droids FotD™

And a 64 Impala

Ricky

nah this is real, zelous wheeler is going to be our giancarlo stanton. hes a tremendous power hitter with all of his two home runs and tanaka will come back in august and throw a no hitter in every one of his starts then jorge posada will come out of retirement and hit a walk off home run in game 7 of the world series with mariano rivera pitching the inning before that

TWTR

I hope he makes a full recovery, and does whatever is necessary to achieve that, no matter how long it takes.

ChristisKing

At some point you just have to laugh.. You’d think that age was the cause of the Yankees having so many injuries, but Pineda is young, Nova is young, Tanaka is young, it’s just crazy….

I wonder what is up with these guys…. It almost seems like injuries have become more part of the game than they were a long time ago… And those guys would throw 130 pitches and can go again 2 days later.

Yan Solo

I think Nolan Ryan has some valid beef about pitchers today. Then again, it’s not the same game he was pitching in I’m afraid.

Evan3457

I thought the Rangers tried Ryan’s theories, and aren’t they having a ton pitching injuries themselves this year?

Old Man Time

They did try his theories, but I don’t know for how long and if it affected this year’s injuries, but, yes, they have been decimated by injuries.

Ethan

what did he say?

bonestock94

In the past, they weren’t throwing this hard for the most part. Both hitters and pitchers are way more powerful these days, training has come a long way. I guess it hasn’t come long enough to deal with the new levels of strain on these arms, though.

Jorge Steinbrenner

I do wonder what people think about some of what David Cone had to say last night about pitchers trying to put more movement on the ball than ever before and how, twenty years ago, guys who threw two-seamers were instantly put in the bullpen. Are we overcomplicating pitching to the point where it’s hurting our young men? I have no clue, but some of it resonated with me where both Ryan and Verducci equally make little sense to me sometimes.

The Big City of Dreams

Are we overcomplicating pitching to the point where it’s hurting our young men?

————–

Maybe. Just look at how many different pitches pitchers throw at different angles with different grips and speeds now a days. Add that to the length of the season and a long post season. It starts to take a toll after a while.

Jorge Steinbrenner

Then they should really take a hard fucking look at what they’re letting young pitchers throw.

The Big City of Dreams

Coming off the steroid era I think organizations started to take an aggressive approach with pitchers. Offense was so one sided it needed to be balanced out. So now it wasn’t just a variety of pitches being thrown but also throwing harder as well. I remember listening to Colin Cowherd one day and he talked about how many pitchers throw harder today as compared to yrs past. He felt it wasn’t just relievers but starting pitchers as well lighting up the radar gun. Factor that into breaking pitchers falling off the table and you can see why the injuries may begin to pile up. And there are a number of ex pitchers who believe to many of today’s pitchers do use their legs enough when pitching and relying too much on their arms.

Broll the American

I believe the strike zone needs to be increased to include pitches up to the letters (as it says in the rule book). Pitches belt high are considered balls today.
Today’s zone is too small and is entirely within the sweet spot of the hitter. If a pitcher tries to pitch within the zone they have to either be completely over powering or have crazy movement on the pitch. A higher strike zone would allow pitchers to achieve strikes with an average 4-seam fastball.

With a higher zone the batter loses some advantage.

I think you’d see less pitches thrown, less injuries, more batters ready to swing and faster games. While you might see less offensive, you might see it even out as a pitcher misses the high zone a bit low with an 89mph 4-seamer and the hitter jumps on it.

Looser trader droids FotD™

The irony is that Cone was the king of arm angles, mixing speeds, etc.

Umbrelladoc

No one knows how to prevent pitching injuries. It’s the holy grail of sabermetrics right now.

Damn. I do not remember that at all. Of course, he has been MIA for a while now and that explains it :) thanks!

Old Man Time

Manny reportedly tore the ligament while rehabbing from a bone bruise and Campos had a fracture in his elbow, then inflammation, then tore the ligament. So Campos lost a season recovering from the fracture before his surgery and Manny’s was delayed due to the bone bruise.

Jorge Steinbrenner

It’s different for Asians.

Old Man Time

The secret of acupuncture.

Jorge Steinbrenner

Sticky rice.

Deep Thoughts

I guess Cashman didn’t learn his lesson about buying shoddy Asian merchandise with no warranty with Wang.

And they’re fucked, they should sell but they won’t. They’ll be a mediocre team just like last year sadly.

Old Man Time

What are they going to sell that will actually benefit the team for next year and beyond?

The Big City of Dreams

Drob seems to be the guy fans are willing to move.

Jorge Steinbrenner

Maybe we should move some of the fans.

The Big City of Dreams

lol and they want Dellin to close. It’s a little too early for that move.

Jorge Steinbrenner

The one silver lining of the potential other half of my suckiest sports week ever would be that, if Lebron were to actually leave to Cleveland, we’d lose all the bandwagon fans once and for all and people would just leave my fucking team alone.

We could lose a few spoiled Yankee fans here and there.

Chip Rodriguez

I thought we lost a number last year.

Jorge Steinbrenner

We could stand to lose a few more. It’ll just mean the rest of will have to work hard to repopulate the earth with Yankee fans.

Farewell Mo

LBJ the first rat off the ship
Losing the bandwagon fans as a silver lining is sure a pretty big stretch. Welcome to lottery ville with us Knicks fans.

Jorge Steinbrenner

Uhhhh….no, buddy. If he leaves, we’ll suffer, but we’ll be back.

I have a lot of thoughts as what, why, etc., but this ain’t the place right now.

Farewell Mo

He leaves then Bosh goes to Houston and Miami loses 50 next year.

Jorge Steinbrenner

Very possible.

The Big City of Dreams

Yea Lebron going back to CLE would great for the die hard Heat fans. It would be funny to see the June 2010 Heat riders look for a new team to follow :D.

Hey Blue

That means you would have to stop being a Heat fan too.

BTW. No worries on Tanaka right?? Pointless for everyone to freak out yesterday right?? You IDIOT

Jorge Steinbrenner

Hey look, a random screen name trolling me. Whooda thunk it.

qwerty

There’s no question that Dellin is the better pitcher on just about every level. Make him the closer and let Robertson go.

The Big City of Dreams

And if Dellin fails and the fans turn on him where do they go?

Old Man Time

Drob has a better K/9 rate.

http://www.riveraveblues.com Mike Axisa

1) Betances hasn’t even pitched a full season yet, let’s pump the breaks on him being better than Robertson.

2) You do realize there are seven bullpen spots, right? Teams are allowed to have more than one great reliever.

Yeah Jeets

Selling DRob would make little sense. Betances was just moved to the ‘pen. Re-sign DRob.

TopChuckie

Merideth mentioned Wainwright, did he come back from a tear without TJ?

n0exit

5 seasons with partial tear. Also Ervin Santana pitched with it. All depends on your pain threshold. Many pitchers have been pitching with elbow soreness for many years, but now they can see in full HD every single strand inside your body so the soreness is accompanied by a diagnosis.

Jorge Steinbrenner

Thanks. Very good to know.

Jimmy

Isn’t a partially torn elbow ligament what caused Banuelos to miss pretty much 2 whole seasons because of the time wasted trying to rehab it before finally giving up and having the surgery?

Old Man Time

No, he had a bone bruise.

Ed

Banuelos and Campos both had bone injuries, then tore their ligaments while rehabbing from the initial injuries.

Bob Michaels

Tanaka should ask Venditte for advice on how to pitch using his left hand

jcruz

Well if the past is any indication of the future of tanaka, the yanks should know this will more than likely lead to surgery. Pelfrey, Harvey and Nova have all had partially torn ucl’s and they all had Tommy John surgery.

rbibaseball

Yeah but Nova’s partial tear was worse, and it had more obvious effects. His command was awful at the beginning of year.

Grant

As long as it’s a really small tear the body can repair the ligament with scar tissue. The prp injection just speeds up the process. A cortisone shot would actually inhibit ligament healing because you need the body’s inflammation to activate. But I too am interested in how many mlb pitchers have come back from this and never had a reoccurrence. I’m sure surgery would not be necessary for average Joe, but to load that ligament with mlb pitching stresses is another story. I bet we see him under the knife with this. It’s a damn shame because his stuff is electric and he was one of the few reasons I watched the Yanks this season. Not to mention going forward with our ace pitcher for the next five years is doubtful now. This sucks.

wilcymoore27

My guess is that no one on this board is an orthopedic surgeon. I have to assume that with rehab a small ligament tear can be overcome. Let’s just see what happens.

qwerty

The UCL does not heal, the point of rehab is to strengthen the muscles around the ligament, not the ligmament itself.

n0exit

This is completely wrong. Ask the university of Phoenix to refund the fees on your MD.

Jorge Steinbrenner

The University of Phoenix actually pays really well. You’d be surprised at how many good professors who can’t find tenure track jobs wind up teaching a few online classes here and there on it.

tom

what is the difference between Nova and Tanaka?

Need Pitching & Hitting

degree of tear

Yan Solo

Yeah. Nova was toast the minute it happened. This could have been much worse, but partial tear still does not bode well no matter how much “lipstick you put on the pig”.

For whatever reason, the Yankees are not given the luxury to rebuild… It’s just not allowed in New York, especially with that kind of budget… I get this sickening feeling that Cashman is about to GUT the farm to pick up some guy who will have some silly contract or be just as injury prone as anyone else…

Old Man Time

When was the last time he “gutted” the farm?

Jorge Steinbrenner

You know….that one season….

ChristisKing

Im saying… Our farm system has been pretty bad for a while.. I remember when the big man on campus was supposed to be Eric Duncan…. We have just never had a deep farm system… Now it’s becoming a little more exciting and with the MLB team getting decimated with injuries, they could get desperate.. You know teams will not give the Yankees a break..

Jorge Steinbrenner

For the most part, the Yankees have not had a good farm system well back into the 1970’s. There’s nothing new going on here. Go to B-Ref and start looking at drafts, year after year.

Hell, look at other team’s drafts as well. You won’t feel so bad after that.

You’re saying they “could get desperate,” but the type of desperation you’re talking about has NEVER occurred. It’d be just as likely that they all grow tits.

CashmanNinja

Even if it’s partially torn with just a small tear…I say just get him under the knife ASAP. 9 times out 10 these rehab stints do NOTHING except prolong the inevitable. Just bite the bullet and do it now instead of dicking around.

FIPster Doofus

I agree. Get it over with. :(

Umbrelladoc

Here’s one reason to be optimistic.

This study from last year shows an 88% success rate with PRP. This is from the Kerlan-Jobe group.http://www.ncbi.nlm.nih.gov/m/pubmed/23666850/
Treatment of partial ulnar collateral ligament tears in the elbow with platelet-rich plasma.
Podesta L1, Crow SA, Volkmer D, Bert T, Yocum LA.
Author information

Abstract
BACKGROUND:
Studies have demonstrated the potential of platelet-rich plasma (PRP) to heal damaged tissue. To date, there are no published reports of clinical outcomes of partial ulnar collateral ligament (UCL) tears of the elbow treated with PRP.
HYPOTHESIS:
Platelet-rich plasma will promote the healing of partial UCL tears and allow a return to play.
STUDY DESIGN:
Case series; Level of evidence, 4.
METHODS:
Thirty-four athletes with a partial-thickness UCL tear confirmed on magnetic resonance imaging were prospectively followed. All patients had failed at least 2 months of nonoperative treatment and an attempt to return to play. Baseline questionnaires, including the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow (KJOC) and Disabilities of the Arm, Shoulder and Hand (DASH) measures, were completed by each patient before injection. Baseline ultrasound measurement of the humeral-ulnar joint space was assessed with 10 lb of valgus stress on the elbow. Each patient received a single type 1A PRP injection at the UCL under ultrasound guidance. The same treating physician at a single institution performed all injections with the same PRP preparation used. Patients completed a course of guided physical therapy and were allowed to return to play based on their symptoms and physical examination findings. Outcome scores, including KJOC and DASH scores, were collected after return to play and were compared with baseline scores. Ultrasound measurements were collected at final follow-up and compared with preinjection values.
RESULTS:
At an average follow-up of 70 weeks (range, 11-117 weeks), 30 of 34 athletes (88%) had returned to the same level of play without any complaints. The average time to return to play was 12 weeks (range, 10-15 weeks). The average KJOC score improved from 46 to 93 (P < .0001). The average DASH score improved from 21 to 1 (P < .0001). The sports module of the DASH questionnaire improved from 69 to 3 (P < .0001). Medial elbow joint space opening with valgus stress decreased from 28 to 20 mm at final follow-up (P < .0001). The difference in medial elbow joint space opening (stressed vs nonstressed) decreased from 7 to 2.5 mm at final follow-up (P < .0001). One player had persistent UCL insufficiency and underwent ligament reconstruction at 31 weeks after injection.
CONCLUSION:
The results of this study indicate that PRP is an effective option to successfully treat partial UCL tears of the elbow in athletes.

Jorge Steinbrenner

Thank you.

tom

Non pitching athletes have successful results. Just hold your breath.

Grant

I agree.
Non pitchers probably fare much much better.

Jorge Steinbrenner

They go back to not pitching 100% of the time.

Grant

I’ll look for a study on this procedure for position players that went on to having long pitching careers after injections. Give me a few minutes on that one.

Umbrelladoc

Just looked at the paper. Of the 34 athletes, 16 were pitchers. Even if all 4 athletes that didn’t respond were pitchers (it doesn’t say) that is still 12/16 or 75%.

n0exit

Hahaha “read the study”. People here don’t want to reason. They want to be hysterical. Thank you for trying though, its really informative.

Vern Sneaker

Let’s hope for the best. How sad, tho. I just love watching him pitch.

Grant

Thanks for the article.
I just wonder how long the study tracked these players after successful reintroduction to playing real games. I bet 88 percent didn’t make it a full year without recurrent symptoms. But if many of them did, than that’s a great sign. We can hope he comes back this season to give it a try so surgery can be performed now instead of after a few starts next year when we go through this all over again.

Umbrelladoc

The paper is from last year, so there isn’t going to be much long term follow up. That’s the kind of thing that might be presented at that conference all the orthopedists were attending.

Umbrelladoc

Actually, it’s there. “At an average follow-up of 70 weeks (range, 11-117 weeks), 30 of the 34 athletes (88%) had returned to play without any complaints.”

TopChuckie

“The average time to return to play was 12 weeks (range, 10-15 weeks).”

That’s the rest of the season.

Grant

Yeah.
I don’t see how we can give it a try with rehab still within this season.
So next year is basically a complete wash when it starts to act up again and we have to have surgery during the season.
With all of our pitchers falling apart, let’s just call Pat Venditte up so he can have TJ surgery on alternating arms after they fall apart.

John Cee

I recall an article from late last year or early this year citing docs have been more conservative with UCL tears as of late. It makes sense not to cut into somebody if a successful, less invasive approach for treatment exists.

Waiting 12 weeks or so is worth the risk to get him back 100% this season. It looks like we’ll know the results by mid-September.

tom

Copy and paste from other site.

RHP Andy Beresford: 4 IP, 3 H, 0 R, 1 BB, 2 K
The 6’7″ right-hander pitched to a 5.06 ERA in 10.2 innings for Charleston earlier this season. Last year, he had a 1.80 ERA here with a 19/5 K/BB ratio over 30 innings. He is already 24 years old (he was a fifth year senior last year for UNLV, and the oldest player the Yankees drafted last year). He has already undergone one Tommy John surgery – when he returned from that, he tore his UCL again on his first pitch. He opted for an alternative therapy (PRP) and became UNLV’s closer. Anyway, as you would suspect with his height, he throws hard (mid-90s) but the secondary stuff is below average.

So that is one. Who others?

tom

I guess doing rehab right is key to succeed. Banuelos and Campos failed during rehabs. umm.

Old Man Time

Those two were rehabbing from different injuries.

Jorge Steinbrenner

Michael Pineda? Ravel Santana?

Old Man Time

What is pine tar? What is Rule 5 draft?

Jorge Steinbrenner

I’m just naming random injured guys. Everyone else is.

J.B. Cox?!

Old Man Time

Sal Fasano.

Deep Thoughts

Eric Duncan. Wait, he wasn’t hurt. What was his excuse again?

Old Man Time

The dot com bubble.

Jorge Steinbrenner

Obama.

Nathan

I think I would have liked either good news or bad news but this is sort of maybe good news, maybe bad news…check back in six weeks.

ruralbob

Amputation

Jorge Steinbrenner

Harikari

Jorge Steinbrenner

Jesus Fucking Christ. The only fucking one of you making any goddamn sense here right now is Kenthadley, who actually asked the only question which needs to be asked here, and that’s what the success rate of rehab and plasma injections is and examples of who’s gone through it successfully.

The rest of you just want any little excuse to tell others that the team’s going to lose. With fans like you, who needs haters. I might as well be talking to a bunch of Sox fans.

So Adam Wainwright and a college kid. Who else do we know of.

It’s not good news, no matter, and know what? It’s time for American baseball to take a hard damn look at itself and what it’s doing to its young pitchers. Seeing young pitcher after young pitcher go down like this sours me on this sport, and I’m sure I’m not the only one. This sport has changed, and it’s not for the best. Melodramatic? Perhaps, but I’m sick of watching young pitchers get hurt like this, even if it’s just a partial tear this time.

Get well, ace, I will be very hopeful that we see you in six weeks. The rest of you better hold down the damn fort for him. GO FUCKING YANKEES.

Macho Man “Randy Levine”

I resent the implication that I do not make sense.

Only the Macho Man “Randy Levine” can accuse the Macho Man “Randy Levine” of not making sense.

Jorge Steinbrenner

Makes sense.

alittleblackegg

If even the *BEST CASE* scenario means our ace is out until mid-August, it is hard to take an optimistic view of 2014. Even if Tanaka is blessed by the plasma fairy, fans should be thinking long term.

Jorge Steinbrenner

Fans should always be thinking long term. What’s your point?

alittleblackegg

Well, I guess my point is that you mentally prepare yourself for a lost season and pray that the current Yankees management has the (to this date unproven) aptitude to acquire a prospect in a trade.

Old Man Time

Prospects are overvalued.

Jorge Steinbrenner

You do you. I’m just fine.

John Cee

You know what’s really hysterical? The Yanks got more than a bucket of balls for Nunez and he, Miguel Sulbaran, is pitching well:

“I think it’s the right decision,” manager Joe Girardi said. “I haven’t really seen anyone rehab a partially torn ligament and have success. It seems what it does is just delay the inevitable of what’s going to happen. Then instead of maybe missing a year and a little bit of time, you miss a couple of years.”

So my follow-up question here is whether there’s a difference between the two tears.

If Girardi said that about Nova, and they go a different route with Tanaka, it is a bit confusing for sure.

Need Pitching & Hitting

There was apparently a difference.
The doctors recommended surgery for Nova, but not for Tanaka.
I’m sure Girardi wasn’t consulted in this decision anyways.

tom

Delia hinted Tanaka did not need TJS right away because he did not lose any velocity and then feel a pop in his elbow like Nova did.

Little pop = TJS.

discomfort = rehab.

Technically, you are correct about degree of tear.

MUIDATS EEKNAY

Even if he does manage to completely heal with rehab, there’s the question of, how’d he manage to tear it so easily in the first place? He didn’t have the tear in his pre-contract MRI. So the fact that this comes up after 3 months in the majors isn’t a great sign for his durability.

Yangeddard Solarte

Phelps pitches a gem but in comes Thorton and coughs it all up like he’s done all season. This combined with the Tanaka news means that the season is over. I’d sell everything we can and see what some of the AAA kids can give us over these last 10 weeks. Fire Cashman, the trainers and Kevin Long.

tom

So Tanaka is eligible for 60 day DL. Take a time and find good deal to get SP.

Need Pitching & Hitting

6 weeks isn’t 60-days

tom

My bad. at least for now.

EndlessJose

I don’t want to give up the season but if we can get a good return on Robertson and Gardner than we have to try.

Tired of seeing the Red Sox not make the postseason badly and benefit(draft or trades) from it.

Old Man Time

Why weaken the team for the next few seasons by trading those two?

MB923

Robertson may leave after this year. Don’t rule it out. Many great teams still don’t have great bullpens (Angels and Tigers for instance). Trading him wouldn’t be the worst idea.

Grant

I’m just going to wait five years for the international draft players to pan out. I hear soccer is really fun to watch.

Jorge Steinbrenner

In five years, you can buy Leonardo Molina his first drink.

Grant

Necisitas una cervesa mi amigo?
Hell, I’m going to have to work on my Spanish. At least I have time.

tom

General manager Brian Cashman said that the doctors involved and the Yankees themselves have had success with this protocol for this level of ligament tear.pecialists in Seattle,New York Yankees’ Masahiro Tanaka has been diagnosed with a partially torn UCL. He will receive an injection and begin a rehab program but will not have surgery, at least not right now.

Does it sound like Nova had different doctor? Did Dr. Admad ever monitor Nova’s injury track prior to the Dr. Andrews operation.

tom

Scratch that. Dr. Ahmad did recommend TJS for Nova. Mystery unsolved.

Jorge Steinbrenner

So Wainwright and the college pitchers underwent the procedure, but already had the surgery previously?

What is the precedent for pitchers who had not previously had the surgery with the rehab?

Farewell Mo

I recall Pettitte pitching for a few years with a partial UCL tear problem is eventually it’s likely to
Need surgery at some point so when that time comes it’s never gonna be convenient to lose him
For 12+ months.

TWTR

As far as I know, he did for his entire career. When he had surgery after checking his swing in Houston, it was on the tendon, iirc.

Ed

Yup, Pettitte’s surgery was for the flexor tendon. Freak injury caused by an awkward swing. The ligament held up fine after the initial scare in ’02.

John

College pitcher here. Partially tore ligament and pitched with it for about 6 weeks, made 4 starts and 2 relief appearances. Can be done, but I eventually tore it and had to undergo TJS.

Jorge Steinbrenner

Did you undergo any sort of alternate treatment, though, or are you referring to the amount of time you tried to pitch through it?

Yankee Rehab

Maybe I’m just looking for someone to be angry with right now, and I know pitching injuries are more prevalent in the game today, but how in the fuck does every young yankee pitching prospect end up with a serious injury…Joba, Hughes, Banuelos, Nova, Pineda, Tanaka…even Chien Ming-Wang. I know his initial injury was a freak injury, but his career was really fucked after they moved him to the bullpen short term in 09 then needed him to start and he hurt his shoulder.

Is all of this pitch count and innings over the year before just a load of shit? What is it? The strength and training program in the offseason? The throwing program in the offseason? What these guys are doing between starts? No one paying attention to their bodies? No one monitoring their mechanics through film study for slight alterations throughout the course of the season?

You’d think they’d have the money to be on the cutting edge of injury prevention instead of just relying on studies of pitchers in the past which only show some correlation between innings pitched over the year before and likelihood of injury.

I don’t know what the fuck it is. It can’t just be a coincidence though. I’ll believe something is a coincidence when it’s just one or two or even three odd occurrences. But 7? Fuck! Someone talk me off the ledge…

Jorge Steinbrenner

Let’s give this a shot….

It’s absolutely not just Yankee pitchers. Put yourself in the shoes of an Atlanta Braves fan right now, or of a Rangers fan.

The rate of increased injury is alarming everywhere. Again, I found David Cone’s comments last night about pitchers trying to put more movement on the ball than ever before to be fascinating. I’ve always found that the idea of specialization being a factor, or that we’re someone developing a generation of wimpier pitching, to just not sound right.

Dan

Fucking sell.

Old Man Time

Again, what are they going to sell that will actually improve the team over the next few seasons?

Sell

Gardner, Ichrio, Kud, Sol, Ellsbury

Jorge Steinbrenner

And what exactly would you get for them which would put the team in a better position? Please.

Old Man Time

Gardner is your best position player, followed by Ellsbury. Ichiro, Kuroda, Solarte won’t net you anything you don’t already have stashed in the minors.

Dan

There is risk involved in every minor leaguer. The larger, more diverse group you have, the better chance you can minimize the risk as a whole and improve your chances of someone becoming the real deal. Say, by trading the guys who have value, they’re able to get 5 new guys in their top 20. That would be great for the future of the franchise–it makes it more likely you develop an impact player.

For potential tradeable assets, I see: Robertson, Gardner, Kuroda, Ellsbury, Betances, McCann, Ichiro, Phelps, and Roberts as guys who are potentially moveable (depending on eating salary where necessary and waiving NTCs). Granted they all have varying degrees of value. But, between those guys they could definitely diversify their farm system and put themselves in position to rebuild.

Old Man Time

Ichiro is not an asset, period. Roberts? C prospect at most.

Kuroda will not waive his NTC unless it’s to a couple of west coast teams which lowers the Yankee’s leverage in obtaining anything better than what they have stashed in the minors.

If you trade Phelps, who takes his place? The team is already down 4 starters.

Drob, Gardner, Ellsbury, McCann can be kept and built around.

Dan

Also, remember, it’s a huge sellers market right now because so many teams are in it. If the Yankees cut their losses they could get a premium on all of their guys. Again, we’re talking about varying value for each guy, but say they can get $1.10 on the dollar for each guy—that would be huge.

Old Man Time

Or they add pieces that are beneficial for years down the road.

Jorge Steinbrenner

Why, Cervelli and DAN for Wacha, Taveras, Piscotty, and Wong.

Dan

I don’t think they should be so short sighted and look at it for the next year or two. This team doesn’t have a good core of players. The reason the 2009 FA spree worked was because that team had a decent core. They should be thinking three years from now–that is the minimum amount of time it will take to get a young core together. You can wheel and deal and improve your system and make trades to fill in assets where necessary. They need a rebuild, no FAs in the next couple of years are going to make this team a World Series contender.

And yes, it’s a fair point that some rebuilds don’t work at all and you end up out of the playoffs for 20 years. But the Yankees have the benefit of financial might. When it’s time, they can spend. If the rebuild doesn’t work, they can spend and at least get back to the point they’re at now.

Old Man Time

If they have to spend to get back to the point they’re at now, then why sell and dip below that for years?

Dan

Because they could rebuild a core in the meantime and actually build a team that can compete for a WS (and have an average age under 30 while doing it). It’s a gamble that could lead to them being an elite team if it works out. It’s a rebuild. Ideally they won’t have to spend $500m in an offseason anytime in the foreseeable future if it works out. I nearly have the worst case scenario.

Deep Thoughts

Lost in all this is what does A-Rod think about it?

FIPster Doofus

A-Rod caused it. It’s his fault.

Old Man Time

He’s texting his Dr for advice.

TWTR

About Ahmad’s medical expertise? That’s probably why the consulted with other doctors….

Jorge Steinbrenner

I just scrolled back up and read Mike’s updated post. Thank you for keeping us updated, and for what’s really an excellent write-up on the topic. You may think their watchability is a two, but your readability’s a ten.

Farewell Mo

This I think we can all agree on.

Farewell Mo

Interesting article by Buster Olney today the gist of which is that many felt it was inevitable that Tanaka break down since the split finger fastball is felt to be an elbow killer and he’s thrown by far the highest percentage among MLB pitchers.

If that’s true, I wonder if the elbow is gonna hold up with a partial tear given the pitch that makes him special is the splitter and he’s gonna have to throw it frequently to be effective

JAG

I really don’t know what to think about the splitter. Pitchers in the US seem to shy away from it, but Tanaka’s hardly alone when it comes to throwing it in Japan. There are also examples of guys like Schilling who threw it for years or careers here without problems. Not to mention the fact that the huge slew of pitchers who got injured this year can’t be attributed to the splitter since most of them don’t throw one.

I’m with Jorge, I think there’s got to be something going on with how young pitchers are handled and trained that is the cause or at least a contributing factor to all these injuries.

Rolling Doughnut

Jorge Steinbrenner on the preceeding article says he will give all the regulars here a free taco meal from his taco stand if the Yankees make the playoffs. Can I get a burrito instead, as tacos give me gas.

Farewell Mo

If he’s taking requests, I’ll have a couple of pasteles, some mofongo and arroz con gandules

Jorge Steinbrenner

This late at night? You’re the one who’s going to wind up with gas.

Kitchen is closed.

Jorge Steinbrenner

This actually even sounds beneath Rolling Doughnut to type.

Derek Jeter

REHAB NEVER WORKS!!!!!!!! There goes this season and next!! REBUILD

Jorge Steinbrenner

Si, Y Si. The Jap pitcher es finito por the anos. Synoara.. He can use dental floss for a blindfold.

Jorge Steinbrenner

The fakes have definitely arrived.

hornblower

Jorge, let them jump off the bridge. I lived through the late sixties. They have had a good run and will be back quickly. No reason not to play some young guys now and see if they have what it takes. Tanaka only pitched one day a week. Games like tonight they have to win. They had several chances to tack on a run and didn’t. They usually get a good six innings out of all their starters. Maybe a few more runs will help. I’m looking forward to watching them if they jettison some of the aged guys and play young.

Jorge Steinbrenner

How’s about asking what A Rod is doing lately, maybe he can pitch.

Jorge Steinbrenner

Not me.

Last comment of the night from me. Assume anything after this is fake.

I am in the camp that rehab will fail…that there is tremendous pre$$ure to bring Tanaka back this year without surgery. The docs feel it too. They are human and as long as there is a thread of a ligament of a chance to pitch without surgery they will go with it. We will see Tanaka pull a Strasburg and be calling the trainer out to take him out of the game sometime in August or September. Brace yourselves….

Maybe Pineda and CC come back strong in ’15!!!

Bronx Boy

NOTE: 3 of the top surgeons in the world all agreed – rehab without surgery. What you have the team do? Ignore the doctors?

Holy Ghost

It seems like just yesterday we all felt like pitching would be the team’s strength this season. Time to write this season off as a loss and start rebuilding for next season.